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A series of catalytically active CeO2/ZnO nanocomposites with different molar ratio (CeO2: 1, 2, 3, 4, 5 and 6 mol%) were successfully synthesized by hydrothermal method. The synthesized nanocomposites were critically investigated using Powder X-ray diffraction technique, Transmission electron microscopy, Selected area electron diffraction and UV–vis diffused reflectance spectra analysis. Powder X-ray diffraction spectra revealed the presence of diffraction peaks of face-centered cubic phase of CeO2 and hexagonal wurtzite phase of ZnO. Transmission electron microscopic analysis revealed that nanocomposites consist of ZnO nanorods and CeO2 nanoparticles; where, CeO2 nanoparticles were clinging on the surface of ZnO nanorods. UV–vis diffused reflectance spectra analysis revealed the good absorption of all the samples towards UV light. The photocatalytic efficiency of CeO2, ZnO and CeO2/ZnO was compared by using methylene blue dye as probe molecule. CeO2/ZnO nanocomposites were found to possess superior photocatalytic activity as compared to their monocomponent counterparts. Furthermore, CeO2/ZnO with 5 mol% CeO2 presented best photocatalytic performance. Additionally, influence of different process variables on the rate of degradation of methylene blue was investigated using CeO2/ZnO with 5 mol% CeO2 as catalyst. Maximum degradation of methylene blue was observed in alkaline region at a catalyst dosage of 1.00 g/L.

This study aims to develop cavitation erosion-resistant clads on stainless steel (SS-316) using the microwave cladding technique. Ni-based alloy powder (EWAC) was reinforced with tungsten carbide (10% by wt) powder to obtain composite clads. The cladding process was carried out in a domestic microwave applicator of 2.45 GHz frequency with 900 W power. The microstructure, crystal structure (phase identification and quantification), and microhardness of the developed clad were investigated with scanning electron microscopy (SEM), energy-dispersive x-ray spectroscopy (EDX), x-ray diffraction (XRD), and Vickers microhardness tester, respectively. It was found that the deposited clad has a uniform thickness of ∼520 μm, and the microstructure mainly consists of equally dispersed and agglomerated carbides in cellular like Ni-Matrix. XRD analysis reveals that the composite clad was composed of various intermetallic, carbide, and oxide phases. The EWAC + 10WC clad (625 ± 81 HV0.3) has a hardness ∼3.5 times higher than the stainless steel substrate (195 ± 15 HV0.3). The cavitation erosion behavior of the SS-316 and EWAC + 10WC clad was examined by using a vibratory cavitation test apparatus. The parametric cavitation erosion testing was conducted according to the Taguchi L9 orthogonal array (OA) to study the effects of variations in amplitude (AMP), immersion depth (ID), and standoff distance (SOD) on mass loss in SS-316 and composite clad. The parametric study results show that SOD was the most influential test parameter, followed by AMP and ID. SOD contributes more than 50% in the mass loss of SS-316 and clad specimens, whereas AMP and ID contribution was around 32%–37% and 7%–11%, respectively. The developed EWAC + 10WC clad performed ∼6.7 times better than the SS-316. Nevertheless, the SS-316 and EWAC + 10WC clad specimens got severely damage in the form of pits, craters, plastic deformation, lip formation, impingement marks, and secondary cracks.

Purpose The aim of this work was to study various retinochoroidal parameters in patients with obstructive sleep apnea syndrome (OSAS) and the effect of interventions on these parameters at 6 months follow-up. Methods A total of 36 patients were recruited prospectively from the otorhinolaryngology clinics of a large tertiary center between September 2018 to March 2020. The subjects were divided into three groups depending upon intervention chosen for OSAS: Group A (surgery, i.e., uvulopalatopharyngoplasty), group B (medical therapy, i.e., continuous positive air pressure) and group C (no intervention). Various retinochoroidal parameters which were studied included retinal thickness (RT), choroidal thickness (CT), choroidal vascularity index (CVI), arteriovenous ratio (AVR), capillary density index (CDI) in superficial and deep retina, at baseline and 6 months of follow-up after the intervention. Results In group A, CT increased significantly at 6 months (332.76 ± 86.41 um) compared to baseline (306.28 ± 78.19) (P = 0.0004). Similarly, CDI at both superficial and deep capillary plexus increased significantly at 6 months (superficial CDI: 0.65 ± 0.04, deep CDI: 0.38 ± 0.01) compared to baseline (superficial CDI: 0.62 ± 0.03, deep CDI: 0.36 ± 0.02) (P = 0.004 and 0.002 respectively). In group B, CT increased significantly at 6 months (361.38 ± 78.63 um) compared to baseline (324.21 ± 76.97 um) (P = 0.008). Also, CVI showed a significant decrease at 6 months (65.74 ± 1.84%) compared to baseline (67.36 ± 1.57%) (P = 0.019). In group C, all except CDI in deep capillary plexus showed a significant decrease at 6 months (0.35 ± 0.01) compared to baseline (0.36 ± 0.02) (P = 0.003). Conclusion OSAS alters various retinochoroidal parameters and timely intervention in patients with OSAS can prevent these alterations. Also, these retinochoroidal parameters could serve as one of the markers to monitor the disease progression.

In 2012, the European Society of Cardiology (ESC) guidelines provided recommendations on the management of ST-elevation myocardial infarction (STEMI). The recommendation from these guidelines is restricted to the European subcontinent. To adapt the updated recommendations for Indian subset of STEMI patients, a panel of experts in the management of STEMI provided their expert opinions. This document provides expert consensus on adapting 2012 ESC STEMI guidelines recommendations in Indian setting. Document also discussed "India-specific" relevant literature to support the consensus opinions provided in the management of STEMI.

Many memory devices store and fetch the data from specific memory location but they require more time for fetching the data. To overcome such issue data needs to be accessed by their content rather than their address. A memory which accesses data in such a way is called the Content Addressable Memory (CAM). The motive of this research work is to combine various Pre-Computational Based CAM (PB-CAM) design methods which helps in optimizing both speed and area of the system. Also, it will help in deploying many applications in various fields such as data compression, fast lookup of routing, firewalls, switches, and routers. The result shows that the proposed parameter extractor circuit is low cost, faster and consumes lesser power. Further improvements in power consumption and speed can be done by combining various techniques such as gated block selection techniques, current race scheme etc. The PB-CAM architecture is implemented in 0.18um, 0.9um and 0.45um technology.

A conventional N-bit flash analog to digital converter has been required the 2N number of resistors and 2N-1 number of preamplifiers as well as comparators. In this proposed work, a number of comparators could be reduced by introducing the multiplexer (MUX). This proposed work has only required the (2^(N-2) + 1) number of comparators. For 6-bit resolution, MUX based flash ADC requires a reduced number of comparators by 73%, respectively, compared with the traditional flash ADC. This proposed 6-bit ADC consists of a reference ladder circuit, a (2x1) multiplexer, 8 (4x1) multiplexer, 17 comparators and thermometer to binary encoder. The proposed 6-bit 200 MSPS ADC is designed and simulated in cadence tools with 1 V supply voltage using 90nm CMOS technology. The proposed work results into effective number of bits (ENOB) of 5.69 bit and figure of merit (FOM) of 0.019 pJ/conversion-step for 200 MS/s.

To augment the performance of the PTL AND gate compared with that of basic AND gate cell with the need of low power and delay which cause the advancement of uncompromising designing approaches to bring down the power consumption significantly. To endure the rising demand, we put forward a low power PTL AND gate cell via forfeit the MOS transistor reckon that shrink the severe threshold loss drawback, considerably improve the speed and drop off the power while relate with the static energy recovery of AND gate when used in adder circuit. The present work links 1.8V, 1.7V, 1.6V, 1.5V, 1.4V, 1.3V, 1.2V, 1.1V, 1.0V MOS transistor PTL AND gate cells in assessment of basic AND gate described in the research literature. We have been worked out for power, delay and power delay product values of all the cells using 0.09µm technology.

Online web service providers generally protect themselves through CAPTCHA. A CAPTCHA is a type of challenge-response test used in computing as an attempt to ensure that the response is generated by a person. CAPTCHAS are mainly instigated as distorted text which the handler must correctly transcribe. Numerous schemes have been proposed till date in order to prevent attacks by Bots. This paper also presents a cross correlation based approach in breaking of famous service provider's text CAPTCHA i.e. PayPal.com and the other one is of India's most visited website IRCTC.co.in. The procedure can be fragmented down into 3 firmly tied tasks: pre-processing, segmentation, and classification. The pre-processing of the image is performed to remove all the background noise of the image. The noise in the CAPTCHA are unwanted on pixels in the background. The segmentation is performed by scanning the image for on pixels. The organization is performed by using the association values of the inputs and templates. Two types of templates have been used for classification purpose. One is the standard templates which give 30% success rate and other is the noisy templates made from the captcha images and success rate achieved with these is 100%.

Highly efficient photocatalytic Ag-decorated ZnO nanopowders were fabricated via photodeposition method. The physical properties of synthesized nanopowders were rigorously investigated using analytical techniques, such as, powder XRD studies, HR-TEM and PL spectroscopy. The surface area of samples was obtained using BET analysis. The potential of synthesized nanopowders as photocatalyst was evaluated by studying the degradation of basonyl violet dye. Coating of ZnO nanopowders with metallic silver resulted in a remarkable improvement in photocatalytic activity. Moreover, most proficient conditions were deduced for the degradation of basonyl violet, by varying parameters, such as, catalyst loading, concentration of dye, and solution pH, using Ag-decorated ZnO nanopowders under UV irradiation.

Background: A CAM is a fully parallel operating device. For high speed data searching functions CAM provides very efficient hardware architecture1. Statistical Analysis: This paper presents novel developments in the recent design of high capacity Content Addressable Memory (CAM) and Pre-computational Based CAM (PB-CAM). A graphical analysis has been shown between PB-CAM using static parameter circuit and proposed parameter circuit for power, delay and power-delay product in 90nm CMOS technology. Findings: There are many techniques made for designing a CAM by taking in mind to get lowpower, low-noise, high-speed, less hardware cost and less data comparisons and with minimum number of transistors and gates. There are, Traditional Dynamic CAM architecture, Ones-Count PB-CAM, Parity function PB-CAM, Remainder function PB-CAM, Block-XOR PB-CAM and Master–Slave Match Line (MSML) design. In this paper we have compared 9T and 7T CAM cell operations. Static parameter circuit is compared with proposed parameter comparison circuit for powerdelay product in 45nm CMOS technology. Applications: CAM function can be used in broader applications, such as data compression, LAN bridges, data comparison, switches, Lookup tables, Asynchronous Transfer Mode (ATM) switches, databases, communication devices, communication networks, tag directories and high speed Ethernet etc.

Background: Characterization of peripheral arterial occlusive disease (PAOD) can be performed with non-invasive angiography using computed tomography (CT). The present study was conducted to evaluate the CT angiographic spectrum of aortoiliac and the lower limb arterial disease in symptomatic patients of peripheral arterial occlusive disease (PAOD) and to classify the lesions according to the Trans-Atlantic Inter-Society Consensus II (TASC II). Methods: The study was carried out in the department of radio-diagnosis in collaboration with departments of cardiothoracic surgery, cardiology and surgery, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi. 50 patients aged above 40 years presenting with symptoms and (or) signs of lower limb peripheral arterial disease were recruited into the study after evaluating the renal function. Patient’s clinical history, ABI index and categories of PAOD according to the classification of Fontaine was noted. CT angiography of aortoiliac and lower limb arteries was performed with Philips Brilliance 40 CT unit. The findings in each CT angiography were analysed in respect to site, number, nature and distribution of the lesions and classified individually according to the TASC II. Results: The patients included in the study were all more than 40 years of age. The age range in the study group was 42 years to 75 years. The majority (86%) were male patients. Smoking and dyslipidemia were found to be the main risk factors in our patients. 24% of patients had documentary evidence of ischemic heart disease. On grading with ABI majority of patients (58%) presented in the end stage of the disease (stage IV). On CT angiography, number of lesions detected was 157. 97.4% of lesions were either stenotic or occlusive and 2.54% are with aneurysm. Maximum number of patients had femoropopliteal lesions followed by aortailiac lesions. 14 Winslow pathways were found in 10 patients. Maximum numbers of femoropopliteal lesions (47.29%) belong to type D, type B lesions account for 50% of total aortoiliac lesions based on TASC II classification. Out of 50, 40 were made follow up. Among them 8 were managed with conservative treatment and remaining 32 managed with treatment based TASC II classification. Conclusions: CT angiography is a reliable noninvasive imaging method for the comprehensive and multi parameter evaluation of patients with PAOD. CT angiographic findings are a highly accurate basis for treatment decisions and planning.

BACKGROUND Due to urbanization, the release of coloured wastewaters from textile industries into various environmental components has increased and is posing a threat to water bodies, so that their eradication from water bodies is necessary. To this end, semiconductor heterogeneous photocatalysis has emerged as a promising tool. However, as is well known, photocatalysis is a surface phenomenon; therefore it is strongly influenced by the fabrication technique employed for its synthesis. To address this issue, the present work demonstrates the dependence of synthetic methodology on photocatalytic efficacy of ZnO catalyst. RESULTS Catalytically active nanostructured ZnO particles were fabricated by five different facile methodologies. The fabricated nanostructures were critically analysed using techniques such as, X-ray diffraction (XRD), high resolution transmission electron microscopy (HR-TEM), Brunauer–Emmett–Teller (BET) and photoluminescence (PL) spectrophotometer. The photocatalytic activity of different ZnO catalysts was compared by using safranin O dye as probe molecule. CONCLUSIONS ZnO nanopowders fabricated by different methodologies were found to display different catalytic efficiencies, which was ascribed to large variations in specific surface area and rate of recombination of electrons and holes. Therefore, it is perceived that ZnO catalyst with best catalytic activity can be utilized to streamline the treatment of dye wastewater and is an ideal catalyst for a practical approach. © 2015 Society of Chemical Industry

Maxillary foreign bodies are usually not uncommon but may remain unnoticed. Unnoticed foreign bodies may lead to chronic sinusitis. Large foreign bodies may also lead to traumatic optic neuropathy by entering into the orbit. We here present a case of large foreign body of maxillary sinus secondary to trauma leading to multiple fractures of facial bony framework along with traumatic optic neuropathy.

Nickel substituted cobalt zinc nanoferrites (Co0.6Zn0.4NixFe2-xO4, x=0.2, 0.4, 0.6, 0.8 and 1.0) were successfully synthesised by sol gel method. FT-IR studies showed two absorption bands in the range of 400-600 cm-1corresponding to the M-O bond in the tetrahedral and octahedral clusters, respectively. Powder X-ray diffraction patterns revealed that all the samples had cubic structure with Fd-3m space group.The lattice constant was observed to increase with increase in nickel substitution, thus altering the unit cell volume. An examination of the magnetic properties revealed an increase in saturation magnetization with increasing Ni concentration upto x=0.4, and a decrease there after.These results could be explained using Neel's collinear two-sub-lattice model and three sub-lattice non-collinear model suggested by Yafet and Kittel. DC resistivity was found to decrease with increase in temperature due to semiconductor nature of nanoferrites. The catalytic activity was found to be maximum at x = 0.2 and further found to decrease with increase in nickel concentration

Treadmill exercise testing is the most common noninvasive test to assess patients with suspected or known cardiovascular disease. Measurement of blood pressure (BP) during exercise stress is cumbersome due to patient motion and hemodynamic changes during exercise. Different population studies give differing levels for abnormal BP response to exercise and there is no unanimity about the level of BP at which exercise test is contraindicated or terminated. However, studies uniformly associate abnormal BP responses to exercise not only with risk of future hypertension but also with cardiovascular events, stroke and mortality. The present article provides a brief account of common precautions in BP measurement, the diagnostic and prognostic significance of different BP responses during exercise stress testing.

Bronchial thermoplasty is an endoscopic therapy for severe asthma. The previously reported, randomised sham-controlled AIR2 (Asthma Intervention Research 2) trial showed a significant reduction in severe asthma exacerbations, emergency department visits and hospitalisations after bronchial thermoplasty. More “real-world” clinical outcome data is needed. This article compares outcomes in bronchial thermoplasty subjects with 3 years of follow-up from the ongoing, post-market PAS2 (Post-FDA Approval Clinical Trial Evaluating Bronchial Thermoplasty in Severe Persistent Asthma) study with those from the AIR2 trial. 279 subjects were treated with bronchial thermoplasty in the PAS2 study. We compared the first 190 PAS2 subjects with the 190 bronchial thermoplasty-treated subjects in the AIR2 trial at 3 years of follow-up. The PAS2 subjects were older (mean age 45.9 versus 40.7 years) and more obese (mean body mass index 32.5 versus 29.3 kg·m−2) and took higher doses of inhaled corticosteroids (mean dose 2301 versus 1961 μg·day−1). More PAS2 subjects had experienced severe exacerbations (74% versus 52%) and hospitalisations (15.3% versus 4.2%) in the 12 months prior to bronchial thermoplasty. At year 3 after bronchial thermoplasty, the percentage of PAS2 subjects with severe exacerbations, emergency department visits and hospitalisations significantly decreased by 45%, 55% and 40%, respectively, echoing the AIR2 results. The PAS2 study demonstrates similar improvements in asthma control after bronchial thermoplasty compared with the AIR2 trial despite enrolling subjects who may have had poorer asthma control., A comparison of the results obtained thus far in PAS2 with AIR2 evaluating bronchial thermoplasty in severe asthma http://ow.ly/sB0X30csDuE

Hypertension is not a typical feature of steroid sensitive nephrotic syndrome (SSNS) and the presence of persistent hypertension is suggestive of significant renal lesion. There is paucity of data regarding occurrence and severity of hypertension in SSNS in pediatric population during remission and was the main objective of this study. In addition, correlation with factors like family history, BMI, and lipid profile was studied. Cross-sectional study conducted at tertiary care center in India including 81 children of infrequent relapsing SSNS between 1 and 10 years in remission and was off steroids. Grading and severity of hypertension were assessed. Statistical analysis was done using SPSS version 21.0. Median age of presentation was 5 years, with male:female ratio of 1.3:1. Out of 81 infrequent relapsing SSNS children, 23.45% (19) had hypertension. Among those children with hypertension (n = 19), 73.68% (14) had positive family history compared to 32.25% (20) in those without hypertension. Positive correlation was found between BP and serum cholesterol and LDL. Of the hypertensive patients, 1 (5.26%) had fundus changes, 2 (10.52%) had features of left ventricular hypertrophy, and 13 (68.42%) had non-nephrotic range proteinuria. There is high incidence of hypertension in NS children during remission. Though significant positive correlation was found with positive family history of hypertension and deranged lipid profile highlighting possibility of essential hypertension in them, there is need for close active monitoring and management of hypertension in them as untreated cases may have significant target organ damage.

Context: Deep neck space infection is a potentially morbid condition characterized by pus collection in various potential and true spaces of the neck. With this study, we attempt to highlight, the changes in etiological factors in the current scenario, and management protocols for deep neck space infections. Furthermore, we studied the prevalence of antibiotic resistance in isolated microorganisms. Aims: To study the etiology, antibiotic sensitivity pattern, and management of deep neck space infections in adults and pediatric patients. Settings and Design: A retrospective analysis of patients undergoing surgical management of deep neck space infections at a tertiary care institute in India. Subjects and Methods: Analysis of records of 222 patients who underwent surgical management for deep neck space infections was done. All the patients received empirical antibiotic therapy within 30 min of hospital admission. The patients treated with conservative management were excluded from the study. Cultures and antibiotic sensitivities were obtained for patients undergoing surgical management. Results: Dental infection (52%) was the most common predisposing factor for deep neck space infections in adults followed by diabetes mellitus (28.2%). Multispace involvement was the most common presentation followed by parapharyngeal space involvement. The majority of the cultures were sterile (42.6%). The most common pathogen on cultures was Staphylococcus aureus (13.1% in adults and 47.4% in pediatric age group). The incidence of methicillin-resistant S. aureus (MRSA) was 22.7%, which was lower than what has been observed in the previous studies. Klebsiella pneumoniae isolates were found to have high incidence of resistance to cefotaxime (50%), cefepime (38.5%), and ceftazidime (75%). Complications were seen in 4.5% (n = 10) of patients with an overall mortality of 0.9% (n = 2). Conclusions: In view of comparatively lower incidence of MRSA, combination of amoxicillin-clavulanic acid along with clindamycin is a reasonable first-line antibiotic therapy for deep neck space infections. In patients with diabetes, amikacin or piperacillin-tazobactam can be added to the regime, as there is a higher incidence of infection by K. pneumoniae. Surgical management remains the mainstay of treatment and is associated with improved outcome.

Zn 1−x Co x Fe 2 O 4 /MWCNTs ( x =0.0, 0.2, 0.4, 0.6 and 0.8) nanocomposites have been synthesized via reverse micelle method using functionalized carbon nanotubes. Powder X-ray Diffraction (XRD) patterns revealed the cubic spinel structure with Fd-3m space group without interfering the peak of CNTs. The fundamental Raman scattering peaks at 310, 460 and 662 cm −1 have been observed due to different vibrational frequencies of Fe 3+ , Co 2+ and Zn 2+ cations. Transmission Electron Micrographs (TEM) confirmed the attachment of nanoferrite particles on the surface of negatively charged CNTs. The saturation magnetization increased with Co 2+ doping, however, no pronounced value of coercivity has been observed suggesting the superparamagnetic character. An increase in conductivity with increase in cobalt ion doping has been observed due to increase in hopping of electron between Co 2+ –Co 3+ ion pair. ZnFe 2 O 4 /MWCNTs composite has been found the best suitable visible light driven catalyst for the degradation of Rodhamine B (50 µM) with upto 99% in 5 h.

VLSI architecture of Syndrome generator is part of well known Reed Solomon codes which is capable of generating syndromes while receiving RS (N, K) Codes from the transmitter. RS codes are customized to achieve a suitable VLSI realization of syndromes which can be further used in error detecting algorithms such as Euclidean, Erasures, Berlekamp"s iterative algorithm and Massey Linear feedback shift register synthesis algorithm. It is assumed to be one of the pipelining stages in the Reed Solomon decoding technique. A MATLAB implementation of syndrome generator with various RS codes having different ranges of bit symbols and codeword was reveal for the purpose of determining syndromes. Hardware intricacy depends only on 2p parity check bytes. Message is encoded in Galois field having 2^m elements. Each Codeword enclose "N" symbol generates syndromes for those "N" symbols. It represented implementation of RS (128, Kx) and RS (64, Ky) with the different values of bits/symbol "m" and different range of Kx & Ky and look into how limit of Zeros and Syndrome varies. KeywordsReed Solomon decoders, pipelining processing, Galois field, VLSI, error detection, generator polynomial.

Background Although improvement in left ventricular (LV) function has been shown to portend superior short-term outcomes in patients with heart failure undergoing cardiac resynchronization therapy (CRT), the durability of this effect at 5 years has not been established. Objective To determine the long-term outcomes of patients undergoing CRT on the basis of the degree of echocardiographic response. Methods We extracted clinical data on a cohort of 880 consecutive patients undergoing the new implantation of a CRT device between September 30, 2003, and August 6, 2007. Patients with an ejection fraction (EF) ≤35% undergoing initial CRT implantation, with an available pre-CRT and follow-up echocardiogram, were included in the final cohort. On the basis of changes in LVEF, patients were categorized into "nonresponders" (change in EF ≤4%), "responders" (EF change 5%–20%), and "super-responders" (change in EF >20%). A Cox multivariate model was performed to determine the effect of response on long-term survival free of LV assist device or heart transplant. Results A total of 526 patients met inclusion criteria, of whom 196 (37.3%) were classified as nonresponders, 236 (44.9%) as "responders," and 94 (17.9%) as "super-responders." In multivariate analysis, "super-responders" had the best survival and nonresponders the worst over a mean of follow-up of 5.3 ± 2.4 years. At 5 years, survival free of LV assist device or heart transplant among super-responders was 82%; responders, 70%; and nonresponders, 48%. Conclusions In patients with heart failure undergoing CRT, survival benefit is durable at 5 years of follow-up and its degree intimately tied to the level of improvement in ventricular function. The prognosis of nonresponders is exceptionally poor.

There is limited national-level data on the prevalence of hypertension among Indian adults; with few studies reporting prevalence according to the 2017 ACC/AHA criteria. This study was conducted to study the impact of a lowered cut-off on hypertension prevalence. A national-level survey was

An accurate diagnosis of Alzheimer's disease warrants symptomatic treatment with an acetyl cholinesterase inhibitor or, in more severe disease, memantine. Here, the authors discuss the properties of the available treatment options.

Introduction Phrenic nerve injury (PNI) is a well-known, although uncommon, complication of pulmonary vein isolation (PVI) using radiofrequency energy. Currently, there is no consensus about how to avoid or minimize this injury. The purpose of this study was to determine how often the phrenic nerve, as identified using a high-output pacing, lies along the ablation trajectory of a wide-area circumferential lesion set. We also sought to determine if PVI can be achieved without phrenic nerve injury by modifying the ablation lesion set so as to avoid those areas where phrenic nerve capture (PNC) is observed. Methods and results We prospectively enrolled 100 consecutive patients (age 61.7 ± 9.2 years old, 75 men) who underwent RF PVI using a wide-area circumferential ablation approach. A high-output (20 mA at 2 milliseconds) endocardial pacing protocol was performed around the right pulmonary veins and the carina where a usual ablation lesion set would be made. A total of 30% of patients had PNC and required modification of ablation lines. In the group of patients with PNC, the carina was the most common site of capture (85%) followed by anterior right superior pulmonary vein (RSPV) (70%) and anterior right inferior pulmonary vein (RIPV) (30%). A total of 25% of PNC group had capture in all 3 (RSPV, RIPV, and carina) regions. There was no difference in the clinical characteristics between the groups with and without PNC. RF PVI caused no PNI in either group. Conclusion High output pacing around the right pulmonary veins and the carina reveals that the phrenic nerve lies along a wide-area circumferential ablation trajectory in 30% of patients. Modification of ablation lines to avoid these sites may prevent phrenic nerve injury during RF PVI.

Bronchial thermoplasty is an endoscopic therapy for severe asthma. The previously reported, randomised sham-controlled AIR2 (Asthma Intervention Research 2) trial showed a significant reduction in severe asthma exacerbations, emergency department visits and hospitalisations after bronchial thermoplasty. More “real-world” clinical outcome data is needed. This article compares outcomes in bronchial thermoplasty subjects with 3 years of follow-up from the ongoing, post-market PAS2 (Post-FDA Approval Clinical Trial Evaluating Bronchial Thermoplasty in Severe Persistent Asthma) study with those from the AIR2 trial. 279 subjects were treated with bronchial thermoplasty in the PAS2 study. We compared the first 190 PAS2 subjects with the 190 bronchial thermoplasty-treated subjects in the AIR2 trial at 3 years of follow-up. The PAS2 subjects were older (mean age 45.9 versus 40.7 years) and more obese (mean body mass index 32.5 versus 29.3 kg·m −2 ) and took higher doses of inhaled corticosteroids (mean dose 2301 versus 1961 μg·day −1 ). More PAS2 subjects had experienced severe exacerbations (74% versus 52%) and hospitalisations (15.3% versus 4.2%) in the 12 months prior to bronchial thermoplasty. At year 3 after bronchial thermoplasty, the percentage of PAS2 subjects with severe exacerbations, emergency department visits and hospitalisations significantly decreased by 45%, 55% and 40%, respectively, echoing the AIR2 results. The PAS2 study demonstrates similar improvements in asthma control after bronchial thermoplasty compared with the AIR2 trial despite enrolling subjects who may have had poorer asthma control.

Synthesis of non-collinear (spin canted) ferrites having the formula, CoCd x Fe2 − x O 4 (x = 0·0, 0·2, 0·4, 0·6, 0·8 and 1·0), has been carried out using the sol–gel auto combustion method. The ferrite samples show an interesting magnetic transition from Neel to Yafet–Kittel configuration, as the Cd2 + concentration is increased beyond x = 0·4. The FT–IR spectra confirm the formation of the metal oxide bond as they exhibit two frequency bands in the range of ~595 cm − 1 and ~450 cm − 1, corresponding to the tetrahedral and the octahedral stretching vibrations of the metal oxide, respectively. The structural evolutions of the nanophase investigated using powder X-ray diffraction (XRD) technique show that the average crystallite size is ~ 35 nm. The magnetic studies reveal that the saturation magnetization, M s , increases up to x = 0·4 and decreases when the value of x is >0·4. It is proposed that the incorporation of Cd2 + ion takes place into the tetrahedral sites and up to x = 0·4, Neel’s model is followed. But for x > 0·4, canting of spins occurs, as explained by Yafet–Kittel (Y–K) model. The d.c. resistivity decreases as a function of temperature, indicating semiconducting nature of the ferrites and the positive value of Seebeck coefficient establishes p-type conduction behaviour for all the ferrite samples.

Objectives: Low power consumption, high-speed and low-cost are the major important needs in several applications like Asynchronous Transfer Mode (ATM) and Giga-bit Ethernet networks. To achieve high-speed parallel data comparisons in internet routers PB-CAM is the one of best hardware approaches. In the present work, PB-CAM is modified for improving performance of CAM architecture. Methods/Statistical Analysis: In PB-CAM unit the main building blocks of the process is parameter extractor, parameter comparison circuit and CAM cell. The PB-CAM is faster and low-power consumption than the traditional CAM. The PB-CAM unit implemented by 180nm, 90nm and 45nm CMOS technology in Cadence. The parameter-extractor and static-parameter-comparison circuits implemented in 180nm, 90nm and 45nm CMOS technology. Findings: The power consumption of the proposed Parameter-Comparison circuit using XNOR-NAND CMOS logic is 0.02135uW at a supply voltage of 0.45V in 45nm CMOS technology for a 4x4 (4-bits of stored parameter-extracted data and 4-bits of input parameter-extracted data) size parameter comparison data at 10-30MHz. For 15-bit input data, the PB-CAM with proposed parameter comparison circuit is consuming an average power of 129.1uW at a supply of 0.9V and a frequency of 10-30MHz. The results show that the PB-CAM unit using proposed parameter comparison circuit is faster, low-power consumption and low-cost than the PB-CAM with static parameter comparison circuit. Application/Improvements: PB-CAM circuit used in high-speed look-up-tables (LUTs), ATMs, routers and etc. In future, further advancements can be done in PB-CAM unit by combining different techniques such as match-line-sense-amplifier, ones-count, block-XOR, parity-bit to achieve low-power, low-cost and high-speed search and read operations in network routers.

Aspergillus fumigatus can cause several allergic disorders including Aspergillus-sensitized asthma, allergic bronchopulmonary aspergillosis (ABPA), and allergic fungal rhinosinusitis (AFRS). ABPA is an immunological pulmonary disorder caused by allergic reactions mounted against antigens of A. fumigatus colonizing the airways of patients with asthma (and cystic fibrosis). Allergic bronchopulmonary mycosis is an allergic fungal airway disease caused by thermotolerant fungi other than A. fumigatus On the other hand, AFRS is a type of chronic rhinosinusitis that is also a result of hypersensitivity reactions to the presence of fungi that become resident in the sinuses. The pathogenesis of ABPA and AFRS share several common features, and in fact, AFRS can be considered as the upper airway counterpart of ABPA. Despite sharing similar immunopathogenetic features, the simultaneous occurrence of the two disorders is uncommon. Due to the lacuna in understanding of the causative mechanisms, and deficiencies in the diagnosis and treatment, these disorders unfortunately are lifelong illnesses. This review provides an overview of the pathogenesis, diagnosis, and long-term outcomes of both these disorders.

There has been a major advancement in managing chronic sinusitis and other sinonasal diseases. There has been a remarkable change in the surgical approach to inflammatory pathology of paranasal sinuses since the time, Messerklinger introduced endoscopic sinus surgery. In this changing scenario of indications for endoscopic sinus surgeries, detailed knowledge of sinonasal anatomy is of paramount importance. It is of utmost importance to master the relevant anatomy and its variations before one embarks upon endoscopic sinus surgery. Various cadaveric and radiological studies have been done to know about the important landmarks and anatomical variations. With increasing horizon of sinus surgery, where more of optic nerve and anterior and middle cranial fossa lesions are being dealt with endoscopically; surgeon needs to be more familiar with various variations in the anatomy of the important structures as even a small mistake can be detrimental to the vision and life of the patient. How to cite this article Gupta AK, Bansal S, Sahini D. Anatomy and Its Variations for Endoscopic Sinus Surgery. Clin Rhinol An Int J 2012;5(2):55-62.

The nasal glioma is a rare congenital nasal abnormality, which manifests as a mass of extracranial cerebral tissue unconnected with the brain. The clinical entity is challenging for several reasons. Their diagnosis may not be immediately obvious at presentation. It is important to exclude an intracranial extension, and for this some have suggested a craniotomy. We report a case of extranasal glioma with intracranial extension was removed successfully by combined extracranial and endoscopic approach without craniotomy. Intranasal endoscopic surgery is a less invasive and safe procedure for the management of nasal glioma and does not result in postoperative facial scarring and deformity. Endoscopic techniques provide excellent visualization and are preferable to the classic frontal craniotomy to exclude intracranial extension of nasal glioma. In this report, the management and the benefits of endoscopy in cases with nasal glioma are discussed. How to cite this article Kalsotra G, Gupta AK, Bansal S, Gupta R. Nasal Glioma An Unusual Presentation in Adult. Clin Rhinol Int J 2012;5(1):49-52.

A new series, of γ-amino butyric acid analogs were designed and synthesized as novel potent GABA-AT inhibitors. A structure–activity relationship study was performed by correlating the effect of different substituents with GABA-AT inhibitory activity of the title compounds. The preliminary bioassays showed that acid hydrazones exhibited excellent inhibitory activities in micromolar (0.07–0.56 μM) range, while Schiff’s bases showed variable results. The most potent compound, 4-amino-N′-[(1Z)-1-(2-bromophenyl)ethylidene]butanehydrazide (AHG177) showed inhibitory potency (IC50) of 0.073 μM. Aminobutyrate transaminase is a pyridoxal-P enzyme which follows a bi–bi ping pong mechanism and in pyridoxamine form can readily transaminate only with succinic semialdehyde and 2-oxoglutarate. The results strongly suggest that only the pyridoxal form of the enzyme is capable of reacting with the ligands. Our findings open up the possibility to extend this protocol to different databases in order to find new potential inhibitor for promising targets based on a rational drug design process.

The structural, magnetic, electrical and optical properties of chromium substituted cobalt ferrites (CoCr x Fe 2− x O 4 , x = 0.2, 0.4, 0.6, 0.8 and 1.0), have been investigated and on the basis of the saturation magnetization values, the cation distribution in the ferrite samples has been proposed. It is suggested that both Co 2+ ions as well as Cr 3+ ions seek to the octahedral sites of the ferrite sub-lattice. However, a small amount of Co 2+ ions are also incorporated in the tetrahedral sites of the ferrite sub-lattice. This causes a decrease in the saturation magnetization ( M s ) values with increasing Cr 3+ concentration. The increase in Cr 3+ ion composition in the ferrite sample decreases the value of saturation magnetization from 77 emu/g to 13 emu/g, indicative of the fact that the lesser magnetic Cr 3+ ions substitute Fe 3+ ions in the octahedral sub-lattice of the ferrites. A significant decrease in the saturation magnetization is observed in CoCrFeO 4 , attributing to the weakening of the A–B interaction as iron enters into the A site. The magnetic moments calculated from the proposed cation distribution (using Neel’s two sub-lattice model) are in conformity with those obtained from M s values. The effect of annealing temperature on structural, magnetic, electrical and optical properties has also been investigated.

The accurate prediction of the binding modes between the ligand and protein is of fundamental importance in modern structure-based drug design. In this study, computational ligand docking methodology, AutoDock 4.0, based on Lamarckian genetic algorithm was employed for virtual screens of a compound library with 233 entries (Schiff’s bases of γ-amino butyric acid) for novel and selective inhibitors of the enzyme γ-amino butyrate aminotransferase (GABA-AT), a potential anticonvulsant drug target. Considering free energy of binding and inhibition constant (KI) as a criteria of evaluation, a total of 43 compounds were predicted to be potential inhibitors of GABA-AT and 11 compounds displayed greater binding affinities than γ-vinyl GABA, Vigabatrin, a well-known GABA-AT inhibitor. Compound SBG164, a dibenzylideneacetone analog; compound SBG195, a 1-methylanthraquinone analog; and compound SBG110, a fenchone analog were the most potent in inhibiting the GABA-AT, in silico. Putative interactions between GABA-AT and inhibitors were identified by inspection of docking-predicted poses. This understanding of protein–ligand interaction and value of KI imparts impetus to the rapid development of prospective GABA-AT inhibitor. It also helps to eliminate the number of false positives and negatives.

In the present study, composites have been synthesized by infiltration of 0.15 wt% carbon steel wool by molten magnesium and AZ91 alloy, which solidifies by cooling under vacuum. The microstructure of the composites observed on a plane normal to the direction of flow shows the transverse section of steel wool strands mostly and clustering of these strands due to pushing by stream of melt during infiltration. The composite based on AZ91 alloy shows network of precipitates of Mg17Al12 along the boundaries of dendrite cells in the matrix, which are significantly finer compared to that in the cast AZ91 alloy. The microhardness of the steel wool in the composite increases with increasing steel wool content, which has been attributed to increased restraining influence of steel wool at higher steel wool content on the plastic flow of the surrounding matrix. The ultimate tensile strength (UTS) is higher in the AZ91 alloy-based composite compared to those observed in the composites based on commercial magnesium, a...

M-type nano hexaferrites MFe 12 O 19 and MAlFe 11 O 19 (M = Sr, Ba and Pb) have been prepared by the sol–gel method to investigate the shielding effect of inorganic ions KCl, KBr and KI on the phase growth of ferrites. FTIR frequency bands in the range 560–580 cm −1 and 430–470 cm −1 corresponds to the formation of tetrahedral and octahedral clusters of metal oxides in ferrites, respectively. X-ray powder diffractographs do not show any peaks for the as obtained samples showing the amorphous nature of the samples, however regular peaks for M-type structure have been obtained for all the annealed samples. There is negligible small change in the lattice parameters ‘ a ’ and ‘ c ’ with substitution of the hexagonal ferrites with aluminium. Magnetic measurements showed that the coercivity (Hc) values of all the samples with KCl and KBr enhance due to KCl and KBr to act as deactivators. However, the coercivity value decreases with KI as it oxidise to I 2 during annealing. The saturation magnetization of the hexaferrites decreases with Al 3+ ion substitution for Fe 3+ ion due to preferential occupancy of aluminium in octahedral sites.

Pyriform sinus fistula belongs to the rarest group of cervical fistulae accounting for 3 to 10% of all branchial anomalies.1The first clinical and embryological studies were described in the early seventies by Sandborn and Tucker, but embryological knowledge in this field remains incomplete. Children and adults usually complaint of painful neck swelling accompanied by fever that is preceded by upper respiratory infection, otalgia and odynophagia. Neonates and infants may have respiratory distress, sometimes with stridor, due to tracheal compression by the abscess.1,5,6However, the most common mode of presentation is the recurrent episodes of acute thyroiditis. Eighty percent of patients with recurrent acute suppurative thyroiditis due to persistent pyriform sinus fistula present during the first decade of life. Making the distinction between third and fourth arch fistulas is difficult on clinical grounds alone and hence they are often collectively termed pyriform sinus fistula. Owing to the rarity of the condition and varied clinical presentation, diagnosis and ultimate management is often delayed leading to undue morbidity to the patient and professional frustration for the treating surgeon. We, hereby, present a case series of three classical cases of complete pyriform sinus fistulas with review of available literature in an attempt to clarify issues regarding presentation, diagnosis and management of this condition.